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Organization

KALEIDOSCOPE PROJECT,INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RICHARD A SIMMONS (CEO)
(330) 518-2652
Entity
Organization

Contact information

Practice address
832 N STATELINE RD, MASURY, OH 44438-1640
(330) 969-1098
Mailing address
6610 PHEASANT RUN DR, CANFIELD, OH 44406-8742
(330) 702-1822

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
343900000X
Non-emergency Medical Transport (VAN)
347C00000X
Private Vehicle
3747P1801X
Personal Care Attendant
376J00000X
Homemaker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2657754
OH
Enumeration date
11/18/2020
Last updated
11/18/2020
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